title: A diagnostic dilemma: a young boy with loss of weight, pulmonary infiltrates and cervical lymphadenitis.
abstract: Cervical lymphadenitis is a common finding in young adults in a country like India, where tuberculosis is endemic. We are presenting the case of a young boy who presented with low grade fever, dry cough, weight loss, and a cervical swelling. His chest X-ray showed diffuse reticulonodular infiltrates. Contrast enhanced CT of chest showed bilateral multiple ring shadows. Cervical lymph node fine needle cytology suggested a metastatic thyroid carcinoma. He was evaluated extensively and a final diagnosis of a familial medullary thyroid carcinoma was made. Medullary thyroid carcinoma should be considered in the differential diagnosis of cervical lymphadenitis with lung infiltrates in young adults. It may be sporadic or a part of an inherited autosomal dominant disorder like multiple endocrine neoplasia. Genetic testing should be done for all patients with a diagnosis of medullary thyroid carcinoma.
authors.affiliation: Clinical Associate Professor, Department of Pulmonary Medicine, Amrita Institute of Medical Sciences , Ponekara, Kochi-682041, Kerala, India .
authors.forename: Asmita A
authors.initials: AA
authors.lastname: Mehta
authors.forename: Sunil
authors.initials: S
authors.lastname: Kumar K
authors.forename: Rajesh
authors.initials: R
authors.lastname: Venkitakrishnan
keywords: Cervical lymphadenitis; Cystic shadows; Familial medullary thyroid carcinoma